The proposed, two-year study seeks to identify determinants of initial and continued use of school mental health services among a sample of rural youth. Drawing from concepts in the recently developed "Network Episode Model" of service utilization, this study is designed to assess predictors of: 1) any mental health service use among the baseline sample of 1310 youth; 2) sector of entry among the 627 youth who reported no previous mental health services at baseline; 3) intensity of school service use among the 458 youth who entered services via schools; and 4) subsequent, non-school service use among the same 458 youth. The youth data set was drawn from the Great Smoky Mountain Study (GSMS), and will be supplemented by a School Survey to collect information on the mental health service resource capacity of the schools where the youth attend. Survival analytic and hierarchical logistic modeling techniques will be used to address the four main research questions. The results of this study will aid policy development by: 1) improving our understanding of the role of youth, parent, and teacher problem recognition on use of and entry into services; 2) identifying important school capacity characteristics associated with use of and entry into services, particularly among youth with highest needs; 3) documenting rural/urban differences in the change in the availability and content of mental health-related resources in schools between 1992 and the present; and 4) providing a baseline profile of the type of mental health-related services in schools for future effectiveness studies.